The reliability of the Triage Assessment System for crisis intervention.

摘要

Both professionals and volunteers who engage in crisis work need an efficient method for assessing an individual's crisis response and for planning an appropriate intervention. Myer and his associates developed a three-dimensional crisis intervention model and a triage assessment rating system (TAS). The Triage Assessment Model assumes individual reactions during crisis are unique, situational, and normal. Three domains are assessed: affective, behavioral, and cognitive. Affective reactions may be anger, fear, or sadness. Behavioral reactions may be categorized as approach, avoidance, or immobility. Cognitive reactions reflect the person's perceptions of transgression, threats of harm, and loss. To accomplish a triage rating, the affective, behavioral, and cognitive domain responses are rated on a scale of 1 to 10 using criteria to mark escalating severity of impairment. A total TAS score, the sum of affective, behavioral, and cognitive domain scores, may be between 3 and 30, with 3 indicating no impairment in function and 30 marking the most severe rating.;The purpose of this study was to examine the inter-rater reliability of the Triage Assessment System when applied to a domestic violence scenario by groups of counseling professionals, social workers, crisis volunteers, and graduate students. Participants completed triage assessment ratings on three video vignettes, each portraying a low, moderate, or high severity of crisis response. The total TAS ratings were analyzed for agreement among raters, consistency in ratings between occupational groups and between groups differing by years of crisis experience.;Results from this study indicate that the TAS has good inter-rater reliability for all three levels of crisis severity, with agreement at or above 75% among the 145 participants in this study. When TAS ratings were compared across groups identified by self-reported occupation and by years of experience, the inter-rater reliability was high. The one exception was a tendency for participants with no crisis experience to be more variable in their rating of the moderately severe vignette than the groups with at least one year of experience. This study supports a high level of reliability for the TAS as a tool for assessing severity of crisis response.